Diana Dolmans

A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8

Background: Preparing healthcare professionals for teaching is regarded as essential to enhancing teaching effectiveness. Although many reports describe various faculty development interventions, there is a paucity of research demonstrating their effectiveness. Objective: To synthesize the existing evidence that addresses the question: “What are the effects of faculty development interventions on the knowledge, attitudes and skills of teachers in medical education, and on the institutions in which they work?” Methods: The search, covering the period 1980–2002, included three databases (Medline, ERIC and EMBASE) and used the keywords: staff development; in-service training; medical faculty; faculty training/development; continuing medical education. Manual searches were also conducted. Articles with a focus on faculty development to improve teaching effectiveness, targeting basic and clinical scientists, were reviewed. All study designs that included outcome data beyond participant satisfaction were accepted. From an initial 2777 abstracts, 53 papers met the review criteria. Data were extracted by six coders, using the standardized BEME coding sheet, adapted for our use. Two reviewers coded each study and coding differences were resolved through discussion. Data were synthesized using Kirkpatricks four levels of educational outcomes. Findings were grouped by type of intervention and described according to levels of outcome. In addition, 8 high-quality studies were analysed in a ‘focused picture’. Results: The majority of the interventions targeted practicing clinicians. All of the reports focused on teaching improvement and the interventions included workshops, seminar series, short courses, longitudinal programs and ‘other interventions’. The study designs included 6 randomized controlled trials and 47 quasi-experimental studies, of which 31 used a pre-test–post-test design. Key points: Despite methodological limitations, the faculty development literature tends to support the following outcomes: Overall satisfaction with faculty development programs was high. Participants consistently found programs acceptable, useful and relevant to their objectives. Participants reported positive changes in attitudes toward faculty development and teaching. Participants reported increased knowledge of educational principles and gains in teaching skills. Where formal tests of knowledge were used, significant gains were shown. Changes in teaching behavior were consistently reported by participants and were also detected by students. Changes in organizational practice and student learning were not frequently investigated. However, reported changes included greater educational involvement and establishment of collegiate networks. Key features of effective faculty development contributing to effectiveness included the use of experiential learning, provision of feedback, effective peer and colleague relationships, well-designed interventions following principles of teaching and learning, and the use of a diversity of educational methods within single interventions.Methodological issues: More rigorous designs and a greater use of qualitative and mixed methods are needed to capture the complexity of the interventions. Newer methods of performance-based assessment, utilizing diverse data sources, should be explored, and reliable and valid outcome measures should be developed. The maintenance of change over time should also be considered, as should process-oriented studies comparing different faculty development strategies. Conclusions: Faculty development activities appear highly valued by participants, who also report changes in learning and behavior. Notwithstanding the methodological limitations in the literature, certain program characteristics appear to be consistently associated with effectiveness. Further research to explore these associations and document outcomes, at the individual and organizational level, is required.

Problem-based learning: future challenges for educational practice and research.

Context  Problem‐based learning (PBL) is widely used in higher education. There is evidence available that students and faculty are highly satisfied with PBL. Nevertheless, in educational practice problems are often encountered, such as tutors who are too directive, problems that are too well‐structured, and dysfunctional tutorial groups.

International handbook of research in medical education

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Solving problems with group work in problem-based learning: hold on to the philosophy.

Problem‐based learning (PBL) has gained a foothold within many schools in higher education as a response to the problems faced within traditional education.

Profiles of effective tutors in problem-based learning : scaffolding student learning

Research on tutoring in problem‐based learning has not focused so far on the variation in tutoring and how this variation can be interpreted by conceptions about effective tutoring.

Analysis of verbal interactions in tutorial groups: a process study

Introduction  Collaborative learning, including problem‐based learning (PBL), is a powerful learning method. Group interaction plays a crucial role in stimulating student learning. However, few studies on learning processes in medical education have examined group interactions. Most studies on collaboration within PBL used self‐reported data rather than observational data. We investigated the following types of interactions in PBL tutorial groups: learning‐oriented interactions (exploratory questioning, cumulative reasoning and handling conflicts about knowledge); procedural interactions, and irrelevant/off‐task interactions.

A short questionnaire to evaluate the effectiveness of tutors in PBL: validity and reliability.

The tutor plays a central role in problem-based learning (PBL). In many PBL-curricula the effectiveness of the tutor is evaluated in order to provide tutors with feedback. In the literature, several tutor evaluation instruments have been described. The problem with many of these instruments is that they are quite long, due to which students become ‘tired’ of filling them out. Using a short questionnaire is more convenient for students, but the question is whether such a short instrument can be valid and reliable. The purpose of this article is to demonstrate the validity and reliability of a short questionnaire (11 items), representing five underlying factors. A confirmatory factor analysis was carried out to assess the adequacy of the five factors. The results demonstrated that the five factor model had a good fit to the data. The alpha coefficients also demonstrated acceptable levels. In conclusion, the short tutor evaluation instrument (11 items) is reliable and valid and can be used for formative and summative purposes.

Clerkship assessment assessed

This article reviews consistent research findings concerning the assessment of clinical competence during the clerkship phase of the undergraduate medical training programme on issues of reliability, validity, effect on training programme and learning behaviour, acceptability and costs. Subsequently, research findings on the clinical clerkship as a learning environment are discussed demonstrating that the clinical attachment provides a rather unstructured educational framework. Five fundamental questions (why, what, when, how, who) are addressed to generate general suggestions for improving assessment on the basis of the evidence on assessment and clinical training. Good assessment requires a thoughtful compromise between what is achievable and what is ideal. It is argued that educational effects are eminently important in this compromise, particularly in the unstructured clinical setting. Maximizing educational effects can be achieved in combination with improvements of other measurement qualities of the assessment. Two concrete examples are provided to illustrate the recommended assessment strategies.This article reviews consistent research findings concerning the assessment of clinical competence during the clerkship phase of the undergraduate medical training programme on issues of reliability, validity, effect on training programme and learning behaviour, acceptability and costs. Subsequently, research findings on the clinical clerkship as a learning environment are discussed demonstrating that the clinical attachment provides a rather unstructured educational framework. Five fundamental questions (why, what, when, how, who) are addressed to generate general suggestions for improving assessment on the basis of the evidence on assessment and clinical training. Good assessment requires a thoughtful compromise between what is achievable and what is ideal. It is argued that educational effects are eminently important in this compromise, particularly in the unstructured clinical setting. Maximizing educational effects can be achieved in combination with improvements of other measurement qualities of the assessment. Two concrete examples are provided to illustrate the recommended assessment strategies.

Student Perspectives on Critical Incidents in the Tutorial Group

The aim of this study is to explore students perceptions of incidents in tutorial groups and their perceptions of the tutors role in these incidents. This study investigated the differences between three types of perceptions: the perceptions of the occurrence of critical incidents in tutorial groups, the perceptions of whether these incidents inhibit tutorial group functioning and the expectations student shave of the role of the tutor with respect to these incidents. Variations in these student perceptions were also investigated for different training levels. The subjects consisted of a stratified random sample of 200 students from first, second, third and fourth year at the Medical School of the University of Maastricht. We used a questionnaire that consisted of a list of 36statements and related descriptions of critical incidents in the tutorial group. Six potential success inhibitors (lack of elaboration, lack of interaction, unequal participation, lack of cohesion, difficult personalities and lack of motivation) were assumed to underlie the statements of the questionnaire. Students were asked to rate each incident on a five-point Likert scale for the three types of perceptions. The major finding of this study was that there are significant differences between the three types of student perceptions. We also found that there are significant differences between perceptions of students in each of the four academic years. We conclude that all potential success inhibitors play a role in explaining dysfunctional tutorial groups. Motivational influences seem to have a particularly strong impact on tutorial group function.

Thinking About Student Thinking: Motivational and Cognitive Processes Influencing Tutorial Groups

THINKING ABOUT STUDENT THINKING: Motivational and Cognitive Processes Influencing Tutorial Groups DIANA DOLMANS;INEKE WOLFHAGEN;CEES VAN DER VLEUTEN; Academic Medicine